2.50
Hdl Handle:
http://hdl.handle.net/10755/157421
Type:
Presentation
Title:
Medication Irregularities Related to Health System Issues
Abstract:
Medication Irregularities Related to Health System Issues
Conference Sponsor:Western Institute of Nursing
Conference Year:2004
Author:Coon, Patricia, MD
P.I. Institution Name:Deaconess Billings Clinic
Title:Medical Director
Contact Address:, Billings, MT, USA
Problem: Persons over age 65 have an average of 3.7 chronic medical conditions. This translates into extensive use of prescription and over the counter medications. The estimated rate of medication errors in hospitalized patients is approximately one per patient per day. When an elderly person is admitted to or discharged from an acute care setting there is an increased potential for system related medication irregularities or errors to occur. These include admission, and discharge. Potential reasons errors can occur include systems failures at the time of admission and discharge including failure of health care professionals to adequately document current medications at admission and discharge that result in medication irregularities and errors. Framework: See overview. Sample: There are 149 subjects over 65 years of age, with a hospital stay >72 hours that have completed study interviews and medical records review. Mean age was 8-+ 8 years, and patients were taking an average of 8 + 3.6 prescription medications on hospital admission and 9 + 4 prescription medications after hospital discharge. Methods: Information on medication usage prior to admission was obtained from the patient and/or their family members. Admission and discharge medication orders, pre-admission medical record information, admission nurse and physician lists, pharmacy information and hospital charts and medication administration records that were compared for both prescription and OTC medications. Incongruencies in medication information was documented and then coded as irregularities or error and the person responsible. Findings: A total of 62 medication errors (average 1.7 + 1.8 per patient) and 23 potential errors (average 0.62+ 1.04 per patient) were detected. Physicians accounted for 65% of the potential medication errors and nurses, 35%. Both medication errors and potential errors were significantly correlated with the number of prescription medications for the subject at both admission (errors r=0.34, p<0.05; potential errors r=0.40, p<0.02) and discharge (errors r=0.34, p<0.05; potential errors r=0.42, p<0.02). Most health care-based medication errors were omission errors (50%) usually from omission of a medication in the admission or discharge orders. Most of these omission errors occurred during the admission process and could be credited to inaccurate initial information obtained from an electronic medical record and/or from the patient. Additional provider-based errors included wrong dose (28%), unauthorized drug (17%) and wrong rate (5%) errors. Conclusions: Nurses need to be aware of the increased potential of medication irregularities or error occurring at the time of hospital admission or discharge. Confirming information obtained from the patient or their family, as well as prior medication history contained in the patients’ medical records, and clearly documenting the medications taken is an important and needed nursing task.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleMedication Irregularities Related to Health System Issuesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157421-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Medication Irregularities Related to Health System Issues</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Coon, Patricia, MD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Deaconess Billings Clinic</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Medical Director</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, Billings, MT, USA</td></tr><tr><td colspan="2" class="item-abstract">Problem: Persons over age 65 have an average of 3.7 chronic medical conditions. This translates into extensive use of prescription and over the counter medications. The estimated rate of medication errors in hospitalized patients is approximately one per patient per day. When an elderly person is admitted to or discharged from an acute care setting there is an increased potential for system related medication irregularities or errors to occur. These include admission, and discharge. Potential reasons errors can occur include systems failures at the time of admission and discharge including failure of health care professionals to adequately document current medications at admission and discharge that result in medication irregularities and errors. Framework: See overview. Sample: There are 149 subjects over 65 years of age, with a hospital stay &gt;72 hours that have completed study interviews and medical records review. Mean age was 8-+ 8 years, and patients were taking an average of 8 + 3.6 prescription medications on hospital admission and 9 + 4 prescription medications after hospital discharge. Methods: Information on medication usage prior to admission was obtained from the patient and/or their family members. Admission and discharge medication orders, pre-admission medical record information, admission nurse and physician lists, pharmacy information and hospital charts and medication administration records that were compared for both prescription and OTC medications. Incongruencies in medication information was documented and then coded as irregularities or error and the person responsible. Findings: A total of 62 medication errors (average 1.7 + 1.8 per patient) and 23 potential errors (average 0.62+ 1.04 per patient) were detected. Physicians accounted for 65% of the potential medication errors and nurses, 35%. Both medication errors and potential errors were significantly correlated with the number of prescription medications for the subject at both admission (errors r=0.34, p&lt;0.05; potential errors r=0.40, p&lt;0.02) and discharge (errors r=0.34, p&lt;0.05; potential errors r=0.42, p&lt;0.02). Most health care-based medication errors were omission errors (50%) usually from omission of a medication in the admission or discharge orders. Most of these omission errors occurred during the admission process and could be credited to inaccurate initial information obtained from an electronic medical record and/or from the patient. Additional provider-based errors included wrong dose (28%), unauthorized drug (17%) and wrong rate (5%) errors. Conclusions: Nurses need to be aware of the increased potential of medication irregularities or error occurring at the time of hospital admission or discharge. Confirming information obtained from the patient or their family, as well as prior medication history contained in the patients&rsquo; medical records, and clearly documenting the medications taken is an important and needed nursing task.</td></tr></table>en_GB
dc.date.available2011-10-26T19:51:27Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:51:27Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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